Hormone therapy could enhance the therapeutic effect of head and facial bone grafts

Bone grafts, which are used to treat head injuries and birth defects, still pose major medical challenges, but scientists are reporting progress toward a new hormone therapy that could improve the outcomes of these surgeries. Their study, which was conducted on mice, appears in the ACS journal Molecular Pharmaceutics.

Zulma Gazit at Cedars-Sinai Medical Center, Edward Schwarz from Rochester University and colleagues note that surgeons perform nearly 100,000 head and facial bone-grafting procedures every year to treat bone loss from disease, birth defects or traumatic injuries. Though this kind of reconstructive surgery dates back to ancient times, the options for implant materials remain limited. Doctors can remove bone from another part of a patient's body or use lab-made materials, but these methods can lead to serious complications. Currently, one of the preferred alternatives is to use bone grafts received from tissue banks, but they often don't join with the bone they're supposed to fix. Preliminary studies have shown that parathyroid hormone (PTH), a drug approved by the U.S. Food and Drug Administration to treat osteoporosis, helps repair fractures in long bones. The team wanted to see if PTH also would help head and facial donor grafts fuse into place.

They tested the hormone in mice with skull defects that they implanted with donor grafts. Daily short-term PTH treatment improved bone formation around the grafts and prevented scar tissue, which can interfere with graft integration, from forming. "These findings will aid in the development of an attractive bone graft, which is readily available, for use in craniofacial reconstruction," they say.

The authors acknowledge funding from the U.S. National Institute of Dental and Craniofacial Research (grant number DE019902).

The American Chemical Society is a nonprofit organization chartered by the U.S. Congress. With more than 163,000 members, ACS is the world's largest scientific society and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.

To automatically receive news releases from the American Chemical Society, contact [email protected].

Bone defects in the craniomaxillofacial skeleton vary from the small (few millimeters) periodontal defects to the large segmental defects resulting from trauma, surgical excision, or cranioplasty. Such defects typically have complex three-dimensional structural needs, which are difficult to restore. In cranial vault defects, the underlying brain needs permanent protection. Segmental jaw defects require restoration of mechanical integrity, temporomandibular joint function, and intermaxillary dental occlusion. Maintaining acceptable facial esthetics is another unique consideration in the treatment of facial defects, which cannot be underestimated. Bone grafts remain the gold standard for reconstructing segmental bone defects. We will overview the status of bone grafting techniques for craniofacial reconstruction, their biological foundation, as well as future directions.